Pancreatic resection for carcinoma of the pancreas and the periampullary region in patients over 70 years of age

Abstract

This study was undertaken to elucidate whether or not resection for cancer of the pancreas and the periampullary region can be performed with an acceptable survival rate in patients over 70 years of age (n = 21) as compared with patients under 70 years of age (n = 47), and whether resection provides an improvement in their prognosis and longevity. The operative mortality for patients over 70 years of age and under 70 years was 10 and 9 per cent respectively and the cumulative 5 years survival 12 +/- 11 and 20 +/- 9 per cent respectively. The median survival was 11 months in both groups. It was concluded that an age of 70 years or more is not an absolute contra-indication for pancreatic resection. Prognosis is related to tumour histology.

The relevance of gastrointestinal fistulae in clinical practice: a review

“…39 The effect of advanced age on operative outcome has also been studied. [40][41][42][43] Perhaps surprisingly, operative mortality did not increase with advancing age in any of these studies although the complication rate in patients aged >80 years was higher than those <80 years in one study (57% v 41%, respectively; p=0.05). 40 Hospital volume has been shown to have a significant effect on total inhospital mortality following pancreatic surgery [44][45][46] and other complex high risk gastrointestinal surgical procedures, 47 although no analysis of the link to fistula formation was made.…”

Establishing Standards of Quality for Elderly Patients Undergoing Pancreatic Resection

“…This rationale was largely based on historical data suggesting marginal improvement in survival, coupled with operative mortality rates as high as 20%. [25][26][27] However, with global improvements in care, current recommendations for management should not consider age alone to be a contraindication for resection. [28][29][30][31] Pancreatic resection, today, like other operations, can be performed safely and frequently in elderly patients.…”

Surgical Treatment of Pancreatic Head Carcinoma in Elderly Patients

“…However, until recently, elderly patients have been excluded by this trend because of the overall unfavorable long-term outcomes that have caused this approach to be considered unadvisable for patients with short life expectancies. 22,[31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] Reduced mortality (Ͻ5%) and morbidity (Ͻ30%) suggest that pancreaticoduodenectomy should be offered to all patients with resectable disease, with no upper age limit. 4,6,12,18,20 Furthermore, populations of developed countries are aging, and age is considered an etiological risk factor for pancreatic adenocarcinoma.…”